Commentary

VA releases results of nationwide audit

The Department of Veterans Affairs (VA) released the results from its Nationwide Access Audit, along with facility level patient access data, medical center quality and efficiency data, and mental health provider survey data, for all Veterans health facilities.

Full details were made public at VA.gov, June 9, following Acting Secretary of Veterans Affairs Sloan Gibson’s commitment last week in Phoenix, Arizona and San Antonio, Texas to provide timely access to quality healthcare Veterans have earned and deserved.

“It is our duty and our privilege to provide Veterans the care they have earned through their service and sacrifice,” said Gibson. “As the President has said, as Secretary Shinseki said, and as I stated plainly last week, we must work together to fix the unacceptable, systemic problems in accessing VA healthcare.”

“Today, we’re providing the details to offer transparency into the scale of our challenges, and of our system itself. I’ll repeat – this data shows the extent of the systemic problems we face, problems that demand immediate actions. As of today, VA has contacted 50,000 Veterans across the country to get them off of wait lists and into clinics. Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our Veterans receive the care they’ve earned.”

Gibson announced a series of additional actions in response to today’s audit findings and data, including:

Establishing New Patient Satisfaction Measurement Program

Gibson has directed VHA to immediately begin developing a new patient satisfaction measurement program to provide real-time, robust, location-by-location information on patient satisfaction, to include satisfaction data of those Veterans attempting to access VA healthcare for the first time. This program will be developed with input from Veterans Service Organizations, outside health care organizations, and other entities. This will ensure VA collects an additional set of data – directly from the Veteran’s perspective – to understand how VA is doing throughout the system.

Holding Senior Leaders Accountable

Where audited sites identify concerns within the parent facility or its affiliated clinics, VA will trigger administrative procedures to ascertain the appropriate follow-on personnel actions for specific individuals.

Gibson has ordered an immediate hiring freeze at the Veterans Health Administration (VHA) central office in Washington D.C. and the 21 VHA Veterans Integrated Service Network (VISN) regional offices, except for critical positions to be approved by the Secretary on a case-by-case basis. This action will begin to remove bureaucratic obstacles and establish responsive, forward leaning leadership.

Removing 14-Day Scheduling Goal

VA is eliminating the 14-day scheduling goal from employee performance contracts. This action will eliminate incentives to engage in inappropriate scheduling practices or behaviors.

Increasing Transparency by Posting Data Twice-Monthly

At the direction of Gibson, VHA will post regular updates to the access data released today at the middle and end of each month at VA.gov. Twice-monthly data updates will enhance transparency and provide the most immediate information to veterans and the public on veterans access to quality healthcare.

Initiating an Independent, External Audit of Scheduling Practices

Gibson has also directed that an independent, external audit of system-wide VHA scheduling practices be performed.

Sending Additional Frontline Team to Address Phoenix

Following his trip to Phoenix VA Medical Center last week, Gibson directed a VHA frontline team to travel to Phoenix to immediately address scheduling, access, and resource requirements needed to provide Veterans the timely, quality healthcare they deserve.

Utilizing High Performing Facilities to Help Those That Need Improvement

VA will formalize a process in which high performing facilities provide direct assistance and share best practices with facilities that require improvement on particular medical center quality and efficiency, also known as SAIL (Strategic Analytics for Improvement and Learning), performance measures.

Applying Immediate Access Reforms Announced in Phoenix to Most Challenged VA Facilities

Gibson announced a series of measures to address healthcare access problems in Phoenix. The VA will apply the same reforms to facilities with the most access problems from the results of the audit.
Hiring Additional Clinical and Patient Support Staff
VA will deploy teams of dedicated human resource employees to accelerate the hiring of additional, needed staff.
Employing New Staffing Measures
VA’s first goal is to get Veterans off wait lists and into clinics. VA is using temporary staffing measures, along with clinical and administrative support, to ensure these Veterans receive the care they have earned through their service.
Deploying Mobile Medical Units
VA will send mobile medical units to facilities to immediately provide services to patients and Veterans awaiting care.
Providing More Care by Modifying Local Contract Operations
VA will modify local contract operations to be able to offer more community-based care to Veterans waiting to be seen by a doctor.
Removing Senior Leadership Where Appropriate
Where appropriate, VA will initiate the process of removing senior leaders. Gibson is committed to using all authority at VA’s disposal to enforce accountability among senior leaders.
Suspending Performance Awards
VA has suspended all VHA senior executive performance awards for fiscal year 2014.
Future Travel
Over the course of the next several weeks, Acting Secretary Gibson will travel to a series of VA facilities across the country. He will hear directly from veterans and employees about obstacles to providing timely, quality care and how VA can immediately address them.

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